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It’s Everyone’s Problem

Jonathan Bernstein has a piece up over at Greg Sargents blog about health care costs. In it he contends that we should (correctly, in my opinion) view the rising cost of healthcare services in the United States as primarily an economic problem, not necessarily as a federal budget problem.

Because, as Mr. Bernstein sufficiently puts it:

Regardless of whether payments come from the federal government, state governments or individual consumers, the nation as a whole will suffer if health costs spiral ever-upward in the next decades.

As I’ve pointed out in the past, there’s plenty of evidence for a factorial explanation for why healthcare costs in this U.S. cost so much more in relation to other OECD countries. But back to Bernstein’s emphasis on the distinction:

But regardless, the United States now spends way more on health care than do comparable nations without getting better results, so there’s room for improvement.

And there’s lots of solid work going on in this front. Yet I can’t help but think that the question should be whether approaching rising healthcare costs as an economic problem rather than a federal budget issue is largely a political distinction without a difference. I understand that from the GOP’s perspective their policy proposals are largely aimed at addressing this issue as a federal budget problem, which has necessarily taken the shortcut of simply shifting costs off the federal balance sheet. Subsequently they believe the result will be a reduction in the growth of healthcare costs (i.e., the economic problem). The Democrats (health policy wonks included) pay particular attention to the issue as an economic problem, which has necessarily taken the initial step of reform through the PPACA. Thus, get everyone signed up, throw the kitchen sink of reform ideas at the whole process, and hope one of them sticks.

It strikes me as someone irrelevant where the origin of attention, or the direction of that attention, goes towards. The relevant factor of concern should be what the effects of proposed policies would be on rising healthcare costs.